| NPI | 1124357959 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMANDA O DINA Lpn 315-952-2250 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: NY 2978261) |
| Enumeration Date | 2009-12-07 |
| Last Update Date | 2009-12-07 |